EDTA依赖性血小板聚集及其对血小板计数的影响  

Influence of EDTA dependent Platelet Aggregation on Platelet Counting

作　　者：关向前[1] 陈发珍 

机构地区：[1]安徽省立医院急诊化验室,合肥230001 [2]微创中心检验科

出　　处：《临床输血与检验》2015年第3期239-242,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨动态分析EDTA-K2依赖性血小板聚集现象随时间的变化。方法随机选取内科门、急诊无血小板聚集的正常EDTA-K2抗凝血常规标本10份(血小板数量大于10×109/L且小于600×109/L的标本5份,小于10×109/L的5份)和出现明显EDTA-K2依赖性血小板聚集的血常规标本10份,其中每份聚集标本备有枸橼酸钠抗凝血标本1份(同一患者)。将各标本于同一时间内,在同等条件下用3种方法(电阻抗法、激光散射法、手工法)进行血小板计数,记录各测定值,用Graphpad prism5软件进行线性回归及相关性分析;在标本采集后不同时间点(30min,60min,90min),用血球仪对聚集标本进行血小板计数,同时涂片瑞士染色观察,动态分析血小板聚集随时间的变化情况。结果无血小板聚集组,3种方法测定值间均具有良好的相关性,相对偏差为临床可接受;血小板聚集现象组,3种方法测定值间相关性较差,相对偏差超出临床可接受范围;当用相应的枸橼酸钠抗凝标本检测时,发现各测定值间相关性较好,其相对偏差亦为临床可接受;此外,随时间推移,EDTA-K2依赖性血小板聚集会逐渐增强。结论血小板聚集会影响血小板检测,使得各方法测定值间失去可比性与相关性,其相对偏差超出临床质控可接受范围,同时血小板聚集现象会随着时间推移更加明显,故一旦发现血小板聚集标本,应尽快进行人工计数,并通知临床重新抽取枸橼酸钠抗凝标本复检。Objective To investigate the influence of platelet aggregation in the clinical detection.Method Ten blood samples of non-EDP patients and EDP patients were collected from clinical laboratory of Anhui Provincial Hospital,and all the samples were treated by EDTA-K2 and citrate sodium,respectively.Under the same condition,each specimen was detected at the same time interval by three different detection systems for platelet counting（laser scattering,electronic resistance,and Artificial methods）,and the data were analyzed.Additionally,in order to observe platelet aggregation dynamically,EDP blood samples were counted at different time points（30min,60 min and 90min）.Results In non-EDPgroup,the detecting values determined between the three methods possessed good correlation,and the relative deviation was clinically acceptable.There was a poor correlation in platelet aggregation group,with the relative deviation out of the clinical acceptable range.In the corresponding citrate sodium anticoagulation specimen,the correlation between the measured values was better than that in the platelet aggregation group,and the relative deviation was also clinically acceptable.In addition,over time,EDTA K2 dependent platelet aggregation gradually increased.Conclusion Platelet aggregation may disturb clinical platelet counting,rendering the values from different systems to lose relation and comparability,and its relative deviation might exceed the acceptable range of clinical quality control.Platelet aggregation becomes more remarlable over time.

关 键 词：血小板计数 血小板聚集 临床可接受性 

分 类 号：R331.143[医药卫生—人体生理学] R446.11[医药卫生—基础医学]